Ann’s Choice
Named and Special Scholarships
2015
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The Fine Arts Scholarship
The H & R Scholarship
Helen E. Slemmer Memorial Scholarship
Daniel and Bertha Memorial Scholarship
Mary Van Wieren Memorial Scholarship
Ann’s Choice Lifelong Learning Academy Scholarship
Bess Vukas Jordan Memorial Scholarship
The Tolerance Scholarship
Important Notes:
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All Special Scholarship recipients must be able to attend the Scholarship Ceremony &
Reception that will be held on Wednesday, June 3, 2015 at 7:00 PM at the Ann’s
Choice Chapel.
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All applicants must be attending school during the fall 2015 term.
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The Selection Committee will interview candidates during the month of May for all Named
and Special Scholarships.
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If you are applying for more than one scholarship you may submit the same essay for
each scholarship (just need to turn in one copy).
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The applications and essays are due to the Philanthropy Department by Friday, March
27, 2015.
Information and requirements about each scholarship are provided in this booklet.
If you have questions about the Named and/or Ann’s Choice Special Scholarships please
contact:
Susan Abtouche
215.443.3159
[email protected]
Fine Arts Special Scholarship
An anonymous resident donor has created a special scholarship for students studying
fine arts at a college or university.
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The applicant must be a graduating senior.
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The applicant must be studying fine arts at a college or university.
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This is a one-time $500 scholarship. (If the recipient demonstrates that he/she is doing well in the fine arts program and continues studying fine arts, the donor may continue to provide the scholarship but this is not guaranteed).
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The applicant can use the same essay written for the Ann’s Choice Scholarship but
should include information regarding the reason for pursuing a fine arts degree in
that essay.
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The applicant must be interviewed by the scholarship selection committee during May
2015.
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The application is due to the Philanthropy Department by March 27, 2015.
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The applicant must be able to attend the Scholarship Ceremony and Reception on the
evening of June 3, 2015.
The H & R Special Scholarship
An anonymous resident donor couple has created a special, one-time $4,000 scholarship for
graduating seniors.
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The applicant must be a graduating senior.
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The applicant must demonstrate financial need.
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This is a one-time $4,000.00 scholarship.
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The applicant must demonstrate a strong work ethic.
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The applicant can use the same essay that is being submitted for the regular Ann’s Choice
Scholarship
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The applicant must be interviewed by the Scholarship selection committee during the
month of May 2015.
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The applicant must be able to attend the Scholarship Ceremony and Reception on the
evening of June 3, 2015.
The Helen E. Slemmer
Memorial Scholarship
The Helen E. Slemmer Memorial
Scholarship will pay $5,000 per
year for up to four years and will be
presented to one staff member per
year. The current balance of the
fund is $109,538.00.
Charles Slemmer
(pictured above) loved living at
Ann’s Choice and said that
the staff members were like
family to him. He wanted to
make a difference in peoples’
lives by creating a scholarship. And he could not think
of a better way to honor his
mother’s memory and have it
live on. As Charles said several years ago, “Nothing would
make my mother happier. I
think she is up there looking
down and smiling right now.”
Charles passed away in 2010.
Charles and his beloved
mother are now together looking down and smiling.
Applicants must:
 Be registered as a full time student at an institution of higher
learning.
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Write an essay regarding what
the scholarship and the education obtained means to him or
her and what it will help him/her
achieve. Graduating seniors
applying for the Ann’s Choice
Scholarship can use the same
essay for this scholarship.
Be interviewed by the Ann’s
Choice Scholarship Selection
Committee during May 2015.
Be able to attend the Scholarship
Ceremony and Reception on the
evening of June 3, 2015.
Have a financial need. Submit
2014 family income verification
form and tax returns. (Social
Security numbers must be
blacked out). Family adjusted
gross income must be less than
$75,000.
Daniel and Bertha
Memorial Scholarship
One-time $4,000 scholarship - can be
divided between multiple recipients.
“My grandparents, Daniel and Bertha (left),
showed great foresight by providing rather
nicely for their grandchildren. Since we tithe
what we are given, we needed to find a use for
some of the money. My grandparents were
not religious. However, they educated all of
their seven children and all of my siblings and
I were educated. Therefore, helping others
get education would be an appropriate way to
use the dedicated money.”
~Anonymous Resident Donor
Applicants must:
 Be an employee (student or any other employee) in good standing.
 Be planning on attending a community college or trade school.
 Have passed his/her 90-day probation period.
 Have exhausted Ann’s Choice assistance (including tuition
reimbursement).
 Student must be paying at least 50% of tuition.
 Complete the application.
 Submit documentation showing financial need and the 2014 family
income verification form. Tax returns should have social security
numbers blacked out.
 Write an essay regarding what the scholarship and the education obtained
means to him or her and what it will help the applicant achieve, including
his or her goals (must by typed). Graduating seniors applying for the
Ann’s Choice Scholarship can use the same essay for this scholarship.
 Be interviewed by the Ann’s Choice Scholarship Selection Committee
during May 2015.
 Be able to attend the Scholarship Ceremony and Reception on the evening
of June 3, 2015.
Mary Van Wieren
Memorial Scholarship
The Mary Van Wieren Memorial Scholarship is for students only (graduating seniors are eligible) and is a one-time $1,500
scholarship. Mary loved the student
workers and education - that is why her
family is creating this scholarship to honor her memory.
Applicants must:
 Be furthering his or her education by attending or taking courses at a 4-year college, a
community college or a trade school. Special
preference will be given to Nursing students
since Mary was a nurse.
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Have a minimum GPA of 3.0
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Write an essay regarding what the scholarship means to him or her and what it will
help the applicant achieve, including his or
her goals. The essay should also include any
volunteer or community service work that the
applicant has done. This essay must be
typed.
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Applicant should have a personality like
Mary (cares about others).
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Must be interviewed by the Ann’s Choice
Scholarship Committee during May 2015.
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Be able to attend the Scholarship Ceremony
and Reception on the evening of June 3,
2015.
Mary Elizabeth Van Wieren, was a retired
nurse. The majority of her career was spent
at Abington Memorial Hospital working in
the operating room as an orthopedic O.R.
nurse. While at Abington, Martha earned
the respect and love of many of the hospital's doctors and nurses because of her funloving, caring, and professional ways.
In 2005, Mary moved to Ann's Choice in
Warminster, where she actively exercised at
the fitness center and pool, volunteered in
the library, delivered meals to other residents, helped as a cubby stuffer, enjoyed
many trips to the theatre, as well as drove
her friends to the grocery store.
Mary's easy going and fun-loving spirit garnered her many friends with whom she loved
sitting and talking with while enjoying dinner.
Ann’s Choice Lifelong Learning Academy Scholarship
The Ann’s Choice Lifelong Learning Academy (ACLLA) is happy to announce that they are offering one $3,000.00 scholarship for the 20152016 school year. This scholarship will be available to any staff member or student staff member who meets the following criteria:
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Applicant must be furthering his or her education by attending or
taking courses at a 4-year college, a community college or a trade
school.
Applicant must write an essay regarding what the scholarship and
education obtained means to him or her and what it will help the
applicant achieve, including his or her goals. This essay must be
typed. Graduating seniors applying for the Ann’s Choice Scholarship can use the same essay for this scholarship.
Applicant must be interviewed by the Ann’s Choice Scholarship
Committee during May 2015.
Application and essay due to the Philanthropy Department by Friday, March 27, 2015.
The scholarship recipient must be able to attend the Ann’s Choice
Scholarship Ceremony on June 3, 2015.
ACLLA Panel
Bess Vukas Jordan
Memorial Scholarship
The Bess Vukas Jordan Memorial
Scholarship is for a 2015 graduating
senior (from high school) and is a
one-time $1,500 scholarship.
Applicants must:

Be furthering his or her education by
attending or taking courses at a 4-year
college, a community college or a
trade school. Special preference will
be given to nursing students since Bess
was a nurse.
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Write an essay regarding what the
scholarship means to him or her and
what it will help the applicant achieve,
including his or her goals. The essay
should also include any volunteer or
community service work that the
applicant has done.
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Applicant should have a genuine
desire for a medical career.
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Must be interviewed by the Ann’s
Choice Scholarship Committee during
May 2015.
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Applicant must complete the application.
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The scholarship recipient must be able
to attend the Ann’s Choice Scholarship
Ceremony on June 3, 2015.
Bess was an army nurse serving both at
home and in Japan and Korea during World
War II and the Korean conflict. After retirement she worked in hospitals in the Smithtown, New York area. A proud, dedicated
professional who read her bible daily, she
earned the respect of many professionals
with whom she worked. Bess encouraged
nursing as a career.
She was a major donor to and member of
the President’s Society, at the Western
Pennsylvania Hospital School of Nursing in
Pittsburgh.
Her husband David resides at Ann’s
Choice.
The Tolerance Scholarship given by Gerald and Miriam Shur
This is a one-time, $1,000 scholarship for a student graduating from high school.
This scholarship is presented to the applicant who best demonstrates a strong understanding of the need for tolerance and respect among all peoples, regardless of their
race, religion, sexual orientation, or political views.
The requirements for this scholarship:
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The applicant must be a graduating senior.
The applicant must be an employee in good standing.
The applicant must write an essay using one or more of the considerations below or
any other that the applicant feels appropriate:
Discuss a situation in which you encountered or observed intolerance (either
toward yourself, or toward someone else) and what you did if anything, in
response.
In what areas of our society do you see a greater need for
tolerance? What could you do in order to ensure that tolerance is
achieved?
Explain a situation in which you acknowledge that you were
wrongly intolerant of others, and why you believe that you
acted the way that you did.
What do you think tolerance means to your generation? Do you
think your generation is more or less tolerant than the generations
before it? Why do you think this?
Members of the Ann’s Choice Scholarship Selection Committee will read
the essays. The Selection Committee will interview the top three applicants
(during May of 2015) and choose one recipient to receive the one-time,
$1,000.00 scholarship.
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The recipient must attend the Scholarship Ceremony on June 3, 2015.
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The applicant must complete the scholarship application.
Scholarship Checklist
Name:______________________________________
I am applying for the following scholarships:
The Ann’s Choice Fine Arts Scholarship
The H & R Special Scholarship
Helen E. Slemmer Memorial Scholarship (include 2014 tax
returns with social security numbers blacked out and complete
Family Income Form). Must have a household adjusted gross
income under $75,000 to be considered.
The Daniel and Bertha Memorial Scholarship (include 2014
tax returns with social security numbers blacked out and complete
Family Income Form). Must have a household adjusted gross
income under $75,000 to be considered.
Mary Van Wieren Memorial Scholarship (must have minimum
GPA of 3.0 and provide documentation such as a high school
transcript or current copy of a report card with GPA listed.)
Ann’s Choice Lifelong Learning Academy Scholarship
Bess Vukas Jordan Memorial Scholarship
The Tolerance Scholarship given by Gerald and Miriam Shur
The Ann’s Choice Fine Arts Scholarship 2015
Name:__________________________________
Address: ________________________________
E-mail address: __________________________
Phone Number: __________________________
Department at Ann’s Choice: _______________
Manager/Supervisor: ______________________
Please complete this form and attach (paper clip) the required documents listed below and turn in
to the Philanthropy Department by 5:00 PM on Friday, March 27, 2015. The Philanthropy Department office is located on the second floor of Liberty Commons or the application can be mailed
to: Ann’s Choice Philanthropy Office, 20000 Ann’s Choice Way, Warminster, PA 18974 (must be
received by March 27, 2015 to be considered). Phone number is (215) 443-3159.
Requirements—Please see all requirements in program booklet.
Must be able to attend the Scholarship Ceremony and Reception on the
evening of June 3, 2015.
Must be furthering his or her education by attending or taking courses at a 4-year college, a community college or a trade school.
Write an essay regarding what the scholarship means to him or her and what it will help him or her
achieve, including what his or her goals are. This essay must be typed.
Must be interview by the Ann’s Choice Scholarship Selection Committee.
Complete the above information regarding contact information.
Sign this application.
Once the application packet is reviewed by the Philanthropy Department and it is determined that you
meet the requirements to be eligible, each eligible applicant will be contacted and move forward to be
interviewed by the Ann’s Choice Scholarship Selection Committee during May 2015.
By signing and dating this document, I understand the requirements that must be fulfilled in order
to be considered to receive this scholarship. I understand that the recipient or recipients will be
determined by the Ann’s Choice Scholarship Selection Committee and their decision is final. This
scholarship is not a preset amount, after interviewing all of the applicants, the selection committee
will determine which applicant or applicants will receive assistance. The assistance given will be
based on need of the applicant and partially based on amount of tuition the applicant is paying.
Signature: ________________________________
Date: ______________________
The H & R Special Scholarship 2015 Application
Name:__________________________________
Address: ________________________________
E-mail address: __________________________
Phone Number: __________________________
Department at Ann’s Choice: _______________
Manager/Supervisor: ______________________
Please complete this form and attach (paper clip) the required documents listed below and turn in to the Philanthropy Department by 5:00 PM on Friday, March 27, 2015. The Philanthropy Department office is located on the second floor of Liberty Commons or the application can be mailed to: Ann’s Choice Philanthropy
Office, 20000 Ann’s Choice Way, Warminster, PA 18974 (must be received by March 27, 2015 to be considered). Phone number is (215) 443-3159.
Requirements
Must be furthering his or her education by attending or taking courses at a 4-year college, a community college
or a trade school.
Write an essay regarding what the scholarship means to him or her and what it will help him or her achieve, including what his or her goals are. This essay must be typed.
Must be interview by the Ann’s Choice Scholarship Selection Committee.
Complete the above information regarding contact information.
Sign this application.
Must be able to attend the Scholarship Ceremony and Reception on the
evening of June 3, 2015.
Once the application packet is reviewed by the Philanthropy Department and it is determined that the applicant has
met the requirements to be eligible, each eligible applicant will move forward to be interviewed by the Ann’s
Choice Scholarship Selection Committee during May of 2015.
By signing and dating this document, I understand the requirements that must be fulfilled in order to be considered to receive this scholarship. I understand that only one staff member will receive the H & R Special
Scholarship and the recipient will be determined by the Ann’s Choice Scholarship Selection Committee and
their decision is final. In addition to the requirements mentioned above, I also understand that if I am the
recipient of the scholarship, I will agree that my name and photo may be used in print materials and on our
TV station and I will attend the Ann’s Choice Scholarship Ceremony on the evening of June 3, 2015. If I am
the recipient of this scholarship, I agree to write a thank you note to the donor.
Signature: ________________________________
Date: ______________________
The Helen Elizabeth Slemmer Memorial Scholarship 2015 Application
Name:__________________________________
Address: ________________________________
E-mail address: __________________________
Phone Number: __________________________
Department at Ann’s Choice: _______________
Manager/Supervisor: ______________________
Please complete this form and attach (paper clip) the required documents listed below and turn in to the Philanthropy Department by 5:00 PM on March 27, 2015. The Philanthropy Department office is located on the second
floor of Liberty Commons or the application can be mailed to: Ann’s Choice Philanthropy Office, 20000 Ann’s
Choice Way, Warminster, PA 18974 (must be received by March 27, 2015 to be considered). Phone number is
(215) 443-3159.
Requirements
Proof of family income (household adjusted gross income under $75,000) for 2014. Please submit copy of 2014 tax
return and complete attached sheet.
Provide documentation of other scholarships and awards granted.
Write an essay regarding what the scholarship will mean to you and what it will help you to achieve. Graduating seniors providing an essay for the regular Ann’s Choice Scholarship can use that essay.
Provide documentation of full-time enrollment (for the fall 2015 semester) at an institution of higher learning. (If you
are deciding between schools, please provide that information).
Complete the above information regarding contact information.
Sign this application.
Must be interview by the Ann’s Choice Scholarship Selection Committee.
Must be able to attend the Scholarship Ceremony and Reception on the
evening of June 3, 2015.
Once the application packet is reviewed by the Philanthropy Department and the Director of Human Resources, and it is
determined that the applicant has met the requirements to be eligible, each eligible applicant will move forward to be
interviewed by the Ann’s Choice Scholarship Selection Committee during May of 2015.
By signing and dating this document, I understand the requirements that must be fulfilled in order to be considered to receive this scholarship. I understand that only one staff member will receive the Helen Elizabeth Slemmer Memorial Scholarship in 2015 and the recipient will be determined by the Ann’s Choice Scholarship Selection Committee and their decision is final. In addition to the requirements mentioned above, I also understand
that if I am the recipient of the scholarship, I will agree that my name and photo may be used in print materials
and on our TV station and I will attend the Ann’s Choice Scholarship Ceremony on the evening of June 3, 2015.
If I am the recipient of this scholarship, I agree to write a thank you note to the donor’s nephew for each year that
I receive the award and to keep him apprised of my progress at school.
Signature: ________________________________
Date: _______________________________
The Daniel and Bertha Memorial Scholarship Award
2015 Application
Name:__________________________________
Address: ________________________________
E-mail address: __________________________
Phone Number: __________________________
Department at Ann’s Choice: _______________
Manager/Supervisor: ______________________
Please complete this form and attach (paper clip) the required documents listed below and turn in to the
Philanthropy Department by 5:00 PM on Friday, March 27, 2015. The Philanthropy Department office
is located on the second floor of Liberty Commons or the application can be mailed to: Ann’s Choice
Philanthropy Office, 20000 Ann’s Choice Way, Warminster, PA 18974 (must be received by March 27,
2015 to be considered). Phone number is (215) 443-3159.
Requirements—Please see all requirements in this program booklet.
Proof of family income (household adjusted gross income under $75,000) for 2014. Please submit copy of
2014 tax return and complete attached sheet.
Provide documentation of other scholarships and awards granted.
Write an essay regarding what the scholarship will mean to you and what it will help you to achieve. Graduating seniors providing an essay for the regular Ann’s Choice Scholarship can use that essay.
Provide documentation of full-time enrollment (for the fall 2015 semester) at an institution of higher learning. (If you are deciding between schools, please provide that information).
Complete the above information regarding contact information.
Sign this application.
Must be interview by the Ann’s Choice Scholarship Selection Committee.
Must be able to attend the Scholarship Ceremony and Reception on the
evening of June 3, 2015.
Once the application packet is reviewed by the Philanthropy Department and it is determined that the applicant
has met the requirements to be eligible, each eligible applicant will be contacted and move forward to be interviewed by the Ann’s Choice Scholarship Selection Committee (residents and Director of Philanthropy) during
May 2015.
By signing and dating this document, I understand the requirements that must be fulfilled in order to be
considered to receive this scholarship. I understand that the recipient or recipients will be determined
by the Ann’s Choice Scholarship Selection Committee and their decision is final. This scholarship is not
a preset amount, after interviewing all of the applicants, the selection committee will determine which
applicant or applicants will receive assistance. The assistance given will be based on need of the applicant
and partially based on amount of tuition the applicant is paying.
Signature: ________________________________
Date: ______________________
2015 Mary Van Wieren Memorial Scholarship
Name:_______________________________________
Phone Number: __________________________
Address: _____________________________________
E-mail address: __________________________
Department at Ann’s Choice: ____________________
Manager/Supervisor: ______________________
Please complete this form and attach (paper clip) the required documents listed below and turn in to the
Philanthropy Department by 5:00 PM on Friday, March 27, 2015. The Philanthropy Department office is
located on the second floor of Liberty Commons or the application can be mailed to: Ann’s Choice
Philanthropy Office, 20000 Ann’s Choice Way, Warminster, PA 18974 (must be received by March 27,
2015 to be considered). Phone number is (215) 443-3159.
Write an essay regarding what the scholarship and education obtained means to you and what it will help you to
achieve. If you are a graduating senior applying for the Ann’s Choice Scholarship you only need to turn in
one essay.
Provide documentation of full-time enrollment (for the fall 2015 semester) at an institution of higher learning.
(If you are deciding between schools, please provide that information).
Complete the above information regarding contact information.
Sign this application .
Must be able to attend the Scholarship Ceremony and Reception on the
evening of June 3, 2015.
Must be interview by the Ann’s Choice Scholarship Selection Committee.
Once your application packet is reviewed by the Philanthropy Department and the Director of Human Resources,
and it is determined that the applicant has met the requirements to be eligible, each eligible applicant will move
forward to be interviewed by the Ann’s Choice Scholarship Selection Committee during May of 2015.
By signing and dating this document, I understand the requirements that must be fulfilled in order to be considered
to receive this scholarship. I understand that only one staff member will receive the Mary Van Wieren Memorial
Scholarship in 2015 and the recipient will be determined by the Ann’s Choice Scholarship Selection Committee
and their decision is final. In addition to the requirements mentioned above, I also understand that if I am the
recipient of this scholarship, I will agree that my name and photo may be used in print materials and on our TV
station and I will attend the Ann’s Choice Scholarship Ceremony on the evening of June 3, 2015. If I am the
recipient of the scholarship, I agree to write a thank you note to the donor and to keep the donor apprised of my
progress at school.
Signature: ________________________________
Date: _______________________________
Ann’s Choice Lifelong Learning Academy Scholarship
2015 Application
Name:__________________________________
Address: ________________________________
E-mail address: __________________________
Phone Number: __________________________
Department at Ann’s Choice: _______________
Manager/Supervisor: ______________________
Please complete this form and attach (paper clip) the required documents listed below and turn in to
the Philanthropy Department by 5:00 PM on March 27, 2015. The Philanthropy Department office
is located on the second floor of Liberty Commons or the application can be mailed to: Ann’s Choice
Philanthropy Office, 20000 Ann’s Choice Way, Warminster, PA 18974 (must be received by March
27, 2015 to be considered). Phone number is (215) 443-3159.
Requirements
Must be furthering his or her education by attending or taking courses at a 4-year college, a community
college or a trade school.
Write an essay regarding what the scholarship means to him or her and what it will help him or her
achieve, including what his or her goals are. This essay must be typed.
Must be interviewed by the Ann’s Choice Scholarship Selection Committee.
Complete the above information regarding contact information.
Sign this application.
Must be able to attend the Scholarship Ceremony and Reception on the
evening of June 3, 2015.
Once your application packet is reviewed by the Philanthropy Department and it is determined that the
applicant has met the requirements to be eligible, each eligible applicant will move forward to be
interviewed by the Ann’s Choice Scholarship Selection Committee during May of 2015.
By signing and dating this document, I understand the requirements that must be fulfilled in order
to be considered to receive this scholarship. I understand that only one staff members will receive
the Ann’s Choice Lifelong Learning Academy Scholarship in 2015 and the recipient will be
determined by the Ann’s Choice Scholarship Selection Committee and their decision is final. In
addition to the requirements mentioned above, I also understand that if I am the recipient of the
scholarship, I will agree that my name and photo may be used in print materials and on our TV
station and I will attend the Ann’s Choice Scholarship Ceremony on the evening of June 3, 2015. If I
am the recipient of this scholarship, I agree to write a thank you note to the donor for each year that
I receive the award and to keep them apprised of my progress at school.
Signature: ________________________________
Date: ______________________
Bess Vukas Jordan Memorial Scholarship
2015 Application
Name:__________________________________
Address: ________________________________
E-mail address: __________________________
Phone Number: __________________________
Department at Ann’s Choice: _______________
Manager/Supervisor: ______________________
Please complete this form and attach (paper clip) the required documents listed below and turn in to
the Philanthropy Department by 5:00 PM on March 27, 2015. The Philanthropy Department office
is located on the second floor of Liberty Commons or the application can be mailed to: Ann’s Choice
Philanthropy Office, 20000 Ann’s Choice Way, Warminster, PA 18974 (must be received by March
27, 2015 to be considered). Phone number is (215) 443-3159.
Requirements
Must be furthering his or her education by attending or taking courses at a 4-year college, a community
college or a trade school.
Write an essay regarding what the scholarship means to him or her and what it will help him or her
achieve, including what his or her goals are. The essay should also include any volunteer or community
service work that the applicant has done.
Must be interviewed by the Ann’s Choice Scholarship Selection Committee.
Complete the above information regarding contact information.
Sign this application.
Once your application packet is reviewed by the Philanthropy Department and it is determined that the
applicant has met the requirements to be eligible, each eligible applicant will move forward to be
interviewed by the Ann’s Choice Scholarship Selection Committee during May 2015.
By signing and dating this document, I understand the requirements that must be fulfilled in order to
be considered to receive this scholarship. I understand that only one staff members will receive the
Bess Vukas Jordan Memorial Scholarship in 2015 and the recipient will be determined by the Ann’s
Choice Scholarship Selection Committee and their decision is final. In addition to the requirements
mentioned above, I also understand that if I am the recipient of the scholarship, I will agree that my
name and photo may be used in print materials and on our TV station and I will attend the Ann’s
Choice Scholarship Ceremony on the evening of June 3, 2015. If I am the recipient of this
scholarship, I agree to write a thank you note to the donor for each year that I receive the award and
to keep them apprised of my progress at school.
Signature: ________________________________
Date: ______________________
The Tolerance Scholarship 2015 Application
Name:_______________________________________
Phone Number: __________________________
Address: _____________________________________
E-mail address: __________________________
Department at Ann’s Choice: ____________________ Manager/Supervisor: ______________________
Please complete this form and attach (paper clip) the required documents listed below and turn in to the Philanthropy
Department by 5:00 PM on Friday, March 27, 2015. The Philanthropy Department office is located on the second floor
of Liberty Commons or the application can be mailed to: Ann’s Choice Philanthropy Office, 20000 Ann’s Choice Way,
Warminster, PA 18974 (must be received by March 27, 2015 to be considered). Phone number is (215) 443-3159.
Write an essay regarding using one or more of the considerations below or any other one that the applicant feels appropriate:

Discuss a situation in which you encountered or observed intolerance (either toward yourself, or toward someone else) and
what you did if anything, in response.

In what areas of our society do you see a greater need for tolerance? What could you do in order to ensure that tolerance is
achieved?

Explain a situation in which you acknowledge that you were wrongly intolerant of others, and why you believe that you
acted the way that you did.

What do you think tolerance means to your generation? Do you think your generation is more or less tolerant than the
generations before it? Why do you think this?
Provide documentation of full-time enrollment (for the fall 2015 semester) at an institution of higher learning. (If you are
deciding between schools, please provide that information).
Complete the above information regarding contact information.
Sign this application and include check list of which scholarships you are applying for.
Must be able to attend the Scholarship Ceremony and Reception on the
evening of June 3, 2015.
Must be interviewed by the Ann’s Choice Scholarship Selection Committee.
Once your application packet is reviewed by the Philanthropy Department and the Director of Human Resources, and it is
determined that the applicant has met the requirements to be eligible, each eligible applicant will move forward to be interviewed
by the Ann’s Choice Scholarship Selection Committee during May of 2015.
By signing and dating this document, I understand the requirements that must be fulfilled in order to be considered to
receive this scholarship. I understand that only one staff member will receive the Tolerance Scholarship in 2015 and the
recipient will be determined by the Ann’s Choice Scholarship Selection Committee and their decision is final. In addition
to the requirements mentioned above, I also understand that if I am the recipient of this scholarship, I will agree that my
name and photo may be used in print materials and on our TV station and I will attend the Ann’s Choice Scholarship
Ceremony on the evening of June 3, 2015.
Signature: ________________________________
Date: _______________________________
Please use for the Helen Elizabeth Slemmer
Memorial Scholarship and the
Daniel & Bertha Memorial Scholarship
2015
Proof Of Family Income
NAME _____________________________________
The household adjusted income must not exceed $75,000. Household income also includes the
the employee’s adjusted gross income.
Father’s Adjusted Gross Income
____________________
Mother’s adjusted Gross Income
____________________
Parents’ Adjusted Gross Income
____________________
(If filing jointly)
Employee’s Adjusted Gross Income
____________________
Other Scholarship Awards
____________________
Total
____________________
Please attach a copy of the previous year’s tax return.
I acknowledge that the above information is true and complete.
Signature___________________________
DATE______________